Types of Wounds When you consider the manner in which the skin or
tissue is broken, there are six general kinds of wounds:
abrasions, incisions, lacerations,
punctures, avulsions, and amputations.
Many wounds, of course, are
combinations of two or more of these basic types.

ABRASIONS.-Abrasions are made when the
skin is rubbed or scraped off. Rope burns, floor burns,
and skinned knees or elbows are common
examples of abrasions. This kind of
wound can become infected quite easily
because dirt and germs are usually
embedded in the tissues.

INCISIONS.-Incisions, commonly called cuts,
are wounds made by sharp cutting instruments such as
knives, razors, and broken glass. Incisions
tend to bleed freely because the blood
vessels are cut cleanly and without
ragged edges. There is little damage to the
surrounding tissues. Of all classes of wounds,
incisions are the least likely to become infected, since
the free flow of blood washes out many of
the microorganisms (germs) that cause
infection.

LACERATIONS.-These wounds are torn,
rather than cut. They have ragged, irregular edges and
masses of torn tissue underneath. These
wounds are usually made by blunt (as
opposed to sharp) objects. A wound made
by a dull knife, for instance, is more likely
to be a laceration than an incision. Bomb fragments
often cause lacerations. Many of the wounds
caused by accidents with machinery are
lacerations; they are often complicated
by crushing of the tissues as well.
Lacerations are frequently contaminated with dirt,
grease, or other material that is ground
into the tissue. They are therefore
very likely to become infected.

PUNCTURES.-Punctures are caused by objects
that penetrate into the tissues while leaving a small
surface opening. Wounds made by nails,
needles, wire, and bullets are usually
punctures. As a rule, small puncture
wounds do not bleed freely; however, large
puncture wounds may cause severe internal bleeding.
The possibility of infection is great in all
puncture wounds, especially if the
penetrating object has tetanus bacteria
on it. To prevent anaerobic infections,
primary closures are not made in the case of puncture
wounds.

AVULSIONS.-An avulsion is the tearing away
of tissue from a body part. Bleeding is usually heavy.
In certain situations, the torn tissue may
be surgically reattached. It can be
saved for medical evaluation by
wrapping it in a sterile dressing and placing it in a cool
container, and rushing it-along with the
victim-to a medical facility. Do not
allow the avulsed portion to freeze,
and do not immerse it in water or saline.

AMPUTATIONS.-A traumatic amputation is
the nonsurgical removal of the limb from the body.
Bleeding is heavy and requires a tourniquet
(which will be discussed later) to stop
the flow. Shock is certain to develop
in these cases. As with avulsed tissue,
wrap the limb in a sterile dressing, place it in a
cool container, and transport it to the hospital with the
victim. Do not allow the limb to be in
direct contact with ice, and do not
immerse it in water or saline. The limb
can often be successfully reattached.

Causes of Wounds Although it is not always necessary to know what
agent or object has caused the wound, it is helpful.
Knowing what has caused the wound may give
you some idea of the probable size of
the wound, its general nature, the
extent to which it is likely to become
contaminated with foreign matter, and what special
dangers must be guarded against. Of special
concern in a wartime setting is the
velocity of wound-causing missiles
(bullets or shrapnel). A low-velocity missile
damages only the tissues it comes into contact with.
On the other hand, a high-velocity missile
can do enormous damage by forcing the
tissues and body parts away from the
track of the missile with a velocity
only slightly less than that of the missile itself. These
tissues, especially bone, may become
damage-causing missiles themselves,
thus accentuating the destructive
effects of the missile.

Having classified the wound into one or more of
the general categories listed, the Corpsman will have a
good idea of the nature and extent of the
injury, along with any special
complications that may exist. This
information will aid in the treatment of the victim.